Individual
MISS ANGIE SOPHIA IRAHETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13130 BURBANK BLVD, SHERMAN OAKS, CA 91401
(818) 781-0360
Mailing address
13130 BURBANK BLVD, SHERMAN OAKS, CA 91401-6000
(818) 781-0360
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ASW84476
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/04/2018
Last updated
11/30/2018
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